Exerciser for the carpal-tarsal joints



Feb. zo, 1951 w. HERMAN 2,542,074

EXERCISER FOR THE CARPAL-TARSALl JOINTS Filed Nov, 26, 1949 20,/ /16 INVENToR. 62x @y 0/64 MLL'qW BRMHN A TTONEY Patented Feb. 20, 1951 EXERCISER FOR THE JOI 11 Claims.

The invention relates to exercisers for the carpal-tarsal joints, that is to say, for the wrists and ankles.

It is the purpose of my invention to provide an exerciser through whose use an improvement can be effected in the condition of paretic and completely paralyzed muscles which `normally move the mentioned joints of the body.

To facilitate explanation of my invention, reference will be made herein to the conventional system of muscle grading, wherein a completely paralyzed muscle is known as grade a muscle which can cause just a flicker of motion is known as grade 1 or as a trace; a muscle which can move a joint, but not against gravity, e. g., can move a joint in water, is known as grade 2 or poor; a muscle which can move a joint against gravity but not against resistance is known as grade 3, or fair; a muscle which can move a joint against some resistance is known as grade 4 or good; and a muscle which is able to move a ,joint against ordinary resistance is known as grade 5 or normal.

For the grade 1 and 2 muscles, an improvement in condition is achieved rst by determining with extreme precision the degree of muscle power remaining and then by applying just the exact minimal amount of assistance to enable that muscle to complete its normal range of movement.

For grade 3 muscles, the desired result is secured by causing the joint to move against a minute resistance which gradually and progressively is increased as the muscle passes to grade 4.

In general I achieve the foregoing aims by providing an exerciser wherein the determination of muscle strength can be made with great precision under the identical conditions prevailing during the administration of exercises used to improve that muscle.

At present, due to the difference in construction of conventional exercisers and testing equipment, an accurate determination of muscle strength and schedule of exercise can not be relied upon to produce uniform results, this diiculty being enhanced by the fact that even small changes in the technique of measuring produce quite considerable changes in results.

Pursuant to my invention such difficulty is overcome by providing an exerciser which performs the dual function of exercising and measuring with the joint identically positioned for both and through whose use an extremely exact measurement of muscle strengthto small fractions or" an ounce-can be obtained.

Another object of my invention is to provide an CARPAL-TARSAL NTS William Bierman, New York, N. Y. Application November 26, 1949, Serial No. 129,664

ycan act as prime movers.

exerciser of the character described which is of extremely simple construction and which is compact and light in weight, so that exercising and measuring can be effected by the patient himself, thereby not only facilitating physical recovery but also psychologically aiding the patient by allowing him to observe constant slight progressive improvement of his condition.

It is another object of my invention to provide an exerciser of the character described which is of such construction that it is inexpensive to manufacture, whereby the same can be made available on a large scale to patients for individual use in the home and hospital, thus permitting the benefit of exercises to be extended to all paretic sufferers and to those who are unable to afford or obtain the use of expensive exercising equipment and/or trained technicians.

It is another object of my invention to provide an exerciser of the character described lthrough whose use the possibility of different people or the same person at different times obtaining different measurements of muscle strength is minimized.

It is another object of my invention to provide an exerciser of the character described which is able to provide the precise amount of assistance or resistance necessary to achieve maximum improvement. With such an exerciser minimal assistance is afforded to grade 1 and 2 muscles and maximal resistance to grade 3 and 4 muscles so that the pareti@ muscle, no matter how weak or how strong, must exert to the utmost degree whatever strength it possesses.

The movement of the carpal-tarsal joints is controlled by several muscles, any group of which y Thus, for example, to flex a foot upwardly about the ankle, there are muscles which can move the foot upwardly and inwardly, muscles which can move the foot upwardly and outwardly and muscles which only can move the foot upwardly. It is an object of my invention to provide an exerciser of the character described which permits evaluation of the strength of less than all of the muscles which move a joint and enables the same tol be exercised selectively.

Other objects of my invention will in part be obvious and in part will be pointed out hereinafter.

My invention accordingly consists in the features of construction, combinations of elements and arrangements of parts which will be exemplified in the device hereinafter described and of 3 which the scope of application will be indicated in the appended claims.

In the accompanying drawings in which is shown one of the various possible embodiments of my invention,

Fig. 1 is a side view of an exerciser constructed in accordance with my invention;

Fig. 2 is a top View thereof;

Fig. 3 is a sectional View taken substantially along the line 3 3 of Fig. l; and

Fig. 4 is a View similar to Fig. 1 but showing the.

apparatus rearranged for a diierent form of exercise than that illustrated in Fig. 1.

Referring now in detail to the drawings, the reference numeral I denotes an apparatus embodying my invention. Said apparatus comprises an elongated platform I2 on which a limb, e. g. a forearm or calf, is adapted to be laid. A support, generally indicated by the reference numeral I4, is connected by a hinge i6 to the platform I2, the axis of rotation of the hinge extending transversely of the longitudinal axis of the platform. Said support. is adapted to. have placed flatly thereon a body extremity such as a hand or foot, and desirably includes means, for instance a strap I8, to hold the hand or foot against the support. Said strap. conveniently may comprise a band having its ends secured, as by tacks, to the support adjacent opposite edges thereof.

For reasons which later will be apparent, the support I includes three parts or panels 28, 22, 22, the lower panel 213. being the one which is connected to the platform, I2 by the hinge I6. Said lower panel is narrower than the ntermediatjff panel 22 and upper panel 20, the latter two of which may be of the same width. The three panels are disposed in end-to-end relationship so that they can be arranged in a common plane, this being the mutual condition indicated in Figs. 1, 2 and 3.

To hold said panels in such position I employ three pins 26, 28, 30. The pin 26 is received in a bore 32 extending from the upper to the lower edge of the panel 20 and in a bore 3d extending downwardly from the upper edge of the panel 22. The pin 28 is received in a bore 36 extending from the upper to the lower edge of the panel 26, in a bore 3B extending from the upper to the lower edge of the panel 22 and in a. bore 48 extending from the upper edge of the panel 24. The pin 38 is received in a bore l2 extending from the upper to the lower edge or" the panel 22 and in a bore 44 extending from the upper edge of the panel 22'. The pins 26, 28 hold the panel 28 to the panel 22 and the pins 28, 3i? hold the panel 22 to the panel 24. The pin 28 is disposed medially of said panels and the pins 25, 36 are located on opposite sides of said medial pin.

The intermediate and upper panels are provided on their front and back surfaces adjacent both side edges thereof with suitable means for detachable connection to elongated ilexible members, such for instance as chains, wires or cords. Such means conveniently may constitute eyes, eyes 26 being on the front of the panel 26, eyes t8 being on the front of the panel 22, eyes 5B being on theback of the panel 20 and eyes 52 being on the back of the panel 22. Said eyes are located further from the medial pin 28 than the edges of the lower panel 24.

The platform I2 has four posts 54, 56, 58, 60 secured thereto in erect position by suitable fastening means. Two of the posts 54, 56 are l muscles normally used for this.

located in front of the support I4, the other two posts being disposed in back of the support. Two posts 54, 58 are located to one side of the support and the other two 56, 68 to the other side of the support.

The apparatus IU also includes several pairs of elongated ilexible members such as wires, chains or cords, of which only two, the cords 82, 6ft, are shown herein. These cords run over certain selected pulleys of a large number of pulleys provided on the apparatus, the selection being made in accordance with the type of exercise or measurement to be furnished or taken. Said pulleys are as follows: A pulley t6 at the top of each front post 5&3, 56, a pulley 66 adjacent the bottom of each front post, a pulley IU adjacent the bottom of each rear post 58, 66, a pulley l2 adjacent the top of each rear post, and a second pulley "I4 adjacent the top of each rear post. The pulleys 66, 68, 'I0 and l2 all are on or adjacent the side of the posts facing the support I 4. The pulley 'I4 is on the side of the post remote from the support I4 and is held away from said post by a bracket 16.

The ends of the cords 62, 64 are provided with means for rapidly detachably securing the same to the eyes 86-52. As illustrated herein such means comprises a spring linger hook 'I3 having a leaf spring secured to its shank and extending over its tip.

The apparatus I6 also includes. a counterweight 82 in the form of. a. weight pan B. having an erect central spindle 86.- at Whose upper end an. eye 88 is provided.

To use the apparatusin aid of a musclewhich raises the foot upwardly about the ankle and which is in a grade 1 or 2 condition, the hooks onone end of each of the cords 62, 6.4 are snapped on the eyes d6 and are threaded in order over the pulleys 66, 68, 70, M. The. narrow panel 26 allows the cord runs between the. pulleys 68 and 'i0 to clear the support IIL. The. hooks on the other ends of the cord are snapped on the eyes 88. The cords areof such length that when so arranged and with the foot raised. the weight pan 84 is not below the level of the platform I2.

The device is placed. on a bed, table or other suitable support and the patients calf rested on the platform with the heel adjacent. the hinge I6 and the sole of the foot. on the front surface of the support. I4, The foot is flexed downwardly about the ankle. by the muscle or purpose, it. being assumed that these are unimpaired or sulciently strong to perform such an action.

Weights 96' are placed on the pan 8f!` These weights are provided in various magnitudes and include even very light weights. in the neighborhood of 1A, of an ounce. The weights are added untilr there is just enough force, together with the full strength of the impaired muscle, to move the foot back to the position illustrated in full lines in Fig, 1. Thismakes the patientV use the impaired muscle at its utmost. strength.

The total value of the. weights on the pan are an accurate measure of the assistance required by the muscle and therefore are. an accurate complemental measure of the strength of the muscle. Moreover, by repeating movement of the-.foot as described, the muscle gradually will strengthen so that the apparatus serves both as an exerciser and a. measuring instrument. Due to its obviously simple construction. the appa- 5.. ratus can be manufactured quite inexpensively and can be made available for use on a wide scale.

After the muscle has reached a grade 3 condition the cords 62, 64' are removed and a shorter set of cords used in lieu thereof. One end of each cord is snapped to the eyes 50 and the cords are threaded only over the pulleys 14, the other ends being snapped on the eyes 88 of the weight pan spindles. The patients foot is slipped under the strap I8. The foot is relaxed and the weights allowed to drag the foot into downwardly flexed position. Then, with the patients muscles, the foot is raised against the weights 90, these weights being exactly balanced to a degree that the muscles of the foot barely can raise the same. Thus in this condition also the apparatus can measure the strength of and exercise the involved muscle.

Should the downwardly flexing muscles of the foot also be aficted and it is desired to assistively exercise grade l or 2 muscles which raise the foot, the cords B2, 66 are set up as indicated in Fig. l. In addition another set of cords have one set of ends snapped on the eyes 59. The latter cords are passed around the pulley 'l2 and the other set of ends are given to the patient who by .pulling on them can swing the board downwardly against the action of the weights 9i! and then permit the weights 9U to assist his impaired muscles in raising the foot.

rThe combined height of the three panels 29, 22, 24 is equal to approximately the length of an average adult foot. With the upper panel 2l) removed, the height of the support is about that of an average adult hand so that when this upper panel is taken away the device can be used for exercise of the muscles which flex the wrist. Moreover, with the upper panel removed the patients toes edge of the intermediate panel 22 so as to enable the patient to secure a better grip on the support I. When said upper panel is removed a substitute pin 28 is used which is shorter than the pin shown in Fig. 3, its length being equal to the height of the panel 22 plus the depth of the bore 4B.

When the device is employed as an exerciser and measuring instrument for the wrist muscles, the cords are connected in the same manner as that indicated for the ankle muscles except that the eyes 48, 52 are used in lieu of the eyes 46, 5B.

Often the weak muscle is but one of a group of muscles which is used to ex the hand or foot in one or another direction. In such case, unless the -proper exercise is given, the ailiicted muscle is not benefited. For example, if the afflicted muscle is the one which moves the foot upwardly and outwardly, the foot Still can be moved upwardly by the muscles which move the foot upwardly and inwardly and the muscle which simply moves the foot,upward1y. In this case exercise of the single aiicted muscle is given by removing the pin 3G and thereby permitting the panels 2i] and 22 jointly to swing about an axis perpendicular to the axis of the hinge l5. rEhe effect of this is to allow the support ifi' to swivel. Only one cord, e. g. the cord Sli, is connected, being secured to the eye on the aiilicted side of the foot. If the bad muscle is a grade l or 2, the cord is connected as indicated in Fig. l to give assistive exercise and it will be observed that the assistive exercise is given in such fashion as may be curled about the upper f over said pulleys, and means to hold to aid the Weak muscle only. If the muscles controlling opposite sides of the foot are afflicted to different degrees, different weights are placed on the weight pans on both sides of the device, thus enabling the exact minimal amount of assistance to be applied separately to the two sides of the foot.

It will be apparent that a similar arrangement can be used to exercise singly afflicted or differently afflicted muscles of the wrist with the panel 20 removed and the pin 3% withdrawn.

It thus will be seen that I have provided a device which achieves all the objects of my invention and is well adapted to meet the conditions of practical use.

As various possible embodiments might be made of the above invention, and as various changes might be made in the embodiment above set forth, it is to be understood that all matter herein described, or shown in the accompanying drawings, is to be interpreted as illustrative and not in a limiting sense.

Having thus described my invention claim as new and desire to secure by Letters Patent:

l. An exerciser and measuring instrument for the carpal-tarsal joints, said exerciser comprising an elongated horizontal platform, a support for a limb extremity, a hinge connecting said support to said platform for rotation about a horizontal axis transverse to the longitudinal axis of the platform, two pairs of vertical posts, one pair in front of and one pair behind the support, one post of each pair being at one side of the support and the other post of each pair being at the other side of the support, a pulley adjacent the top of each front post on the side of the post facing the support, a pulley adjacent the top of each rear post on the side of the post facing away from the support, a pair of elongated flexible members, a pair of means to removably support a .plurality of weights, means detachably connecting an end of each of said members to a different one of said weight supporting means and the other end to a different side of the support with said members guided over'said pulleys, and means to hold a limb extremity on said Support.

2. An exerciser and measuring instrument for the carpal-tarsal joints, said exerciser comprising an elongated horizontal platform, a support for a limb extremity, a hinge connecting said support to said platform for rotation about a horizontal axis transverse to the longitudinal axis of the platform, two 'pairs of vertical posts, one pair in front of and one pair behind the support, one post of each pair being at one side of the support and the other post of each pair being at the other side of the support, a pulley adjacent the top of each front post, apulley adjacent the top of each rear post, a pair of elo-ngated flexible members, a pair of means to removably support a plurality of weights, means detachably connecting an end of each of said members to a different one of said weight supporting means and the other end to a different side of the support with said members guided av limb extremity on said support.

3. An exerciser and measuring instrument for the canpal-tarsal joints, said exerciser comprising an elongated horizontal platform, a support for a limb extremity, ya hinge connecting said support to said platform for rotation about a horizontal axis transverse to the longitudinal axis of the platform, two pairs of vertical posts, one spair in front ofand one pair behind the anatre 7. support, one post of each pair' being at one side of the` support and' the other post of each pair beingV at the other side of the support, a pulley adjacent they top and. bottom of each post on the si'de'thereof facing the support, a pulleyadjacentv the to-p of each rear postv on the side thereof facing-.away from the support, a pair of elongated exible members, a pair of means to removably support a plurality of Weights, means on the. front and back at both sides of the support constituting: one-half of a rapidly detachable attaching means, means on an end ofY each member constituting the other half of said rapidly' detachable attaching means', means detachaibly connecting the other end of each member to a different one of the Weight supporting means, and means to holdy a limb extremity on4 said support.

4. An exerciser and measuring instrument for the. carpal-tarsal joints, said exerciser comprising an elongated horizontal platform, a support for a limb extremity, a hinge connecting said support to said platform for rotation about ahorizontal axis transverse'to the longitudinal axis of the platform, at least four pulleys, means to support two of said pulleys in front and on opposite sides. of the support and above the platform, means to support the other two pulleys in back and.v on opposite sides of the support above the platform and beyond an edge thereof, a pair of elongated flexible members, means on the front and back at both sides of the support constituting one-half of a. rapidly detachable at'- tachingY means, meanson an end of each member constituting the other' halfv of said rapidly de*- tachable attaching means, meansl detachably connecting the other end of each member to a different' one of the Weight supporting means, and means -to hold a limb extremity on' said support.

5. An exerciser and; measuring. instrument for the carpal-tarsal joints, said` exerciser comprisingv an elongated; horizontal platform, a support. fora limb. extremity, a hinge connecting said. support to said. platform for rotation about a horizontal axis transverse to the longitudinal axis' of. the platform, at least four pulleys, meanszsto support two. of said pulleys in front andv on-V p'- lpositeV Sides ofv the support and abovey the' plat;- form, means to support the other two pulleysin back and on opposite sides of the support above the platform and beyond an edge thereof, af pair of elongated flexible members, apair of meansto removably supportl aplurality of weights,- means detachably connecting anend of each of' said@ members to av different oner of said weightsups porting means and the other end to a different side of the support withn saidA members guidedi over said pulleys, and means to holdl'a liinb-=exL tremity on said support.

6. .An-exerciser andl measuring instrumentfor the carpal-tarsal joints, said exerciser. comprising anV elongatedhorizontal platform, aI support for alim'o extremity, a hinge connecting' said' support to said platform for rotation about-a horizontal axis transverse to the" longitudinali axis of the platform, means=to mountsaid` sup` port for rotationI relative to= saidhinge' about an axis transverse tosa-id horizontal' axis, two-pa-irs of vertical posts, one pair infrontl of andi one pair' behind the support, one post of '-eaeh` pair; being-1 at one side of the supportandthe other post of` each pair being at thel other side of? the' support, ai pulley adjacentthe top-of eachfront post, avpulleyf ada'c'entfthe top 'offeachirearfpost- Viv ani axis transverse-to al pair off elongated iiexible members, aA pair of' f the carpal-tarsalf joints, said exerciser comprisingA an elongated horizontal platform, a support for a limb extremity, a hinge connecting said support to said platform for rotation about a 'horizontal axisvtransverse to.` the longitudinal axis of the platform, means' to mount said support for rotation relative to` said hinge about an axis transverse to said horizontal axis, two pairs of vertical posts, one pair infront of and one pair behind the support one post of each pair being atone side of the support and the other post of each pair being at the other side of the support, a pulley: adjacent the top and bottom of each post onthe sidefthereof facing the support, a pulley adjacent the topl of each rear post on the side thereof' facing away from the support, a pair of elongated fiexiblel members, a pair of means to removably'support a plurality'of weights, means on the frontand back at both sides of the support constituting one-half of a` rapidly detachable attaching means, means on an end of each member constituting ly detachable attaching means, means detachably connecting the other end of each member to a different one of the weight supporting means, and means to holdY alimb extremity on said support.V

8. An exerciser and measuring instrument for the carpal-tarsalr joints, said exerciser comprising: an. elongated horizontal platform, a support for a limb extremity, a hinge connecting said support'to` said platform for rotation about a horizontal. axistransverse to the longitudinal axis of the platform, means to-mount said suppor-t for rotation relative to'said hinge about an axis transverse tosaid horizontal axis, means selectively to render said last-named means ineffective, two pairs of vertical posts, one pair in front of and one pair behind the support,. one post of each pair beingat one side of the support and the other post of eachpair being at the other side of the support, av pulley adjacent the top and-bottom of each poston the side thereof facing the support, a pulley adjacent the top of veach rear post onthe side thereof facing awayA from the support,. aA pairv of elongated flexible members, a pair of means tol removably support a plurality ofA weights, means on the front and back at both sides of the' support constituting onehalf of a rapidly detachable attaching means, means on an end of each member constituting the other half of said rapidly detachable attaching means, means detachably connecting the other end of each member toy a different one of the weight supporting'means;r and means to hold a limb'extremity on said support.

9. An exerciser and measuring instrument for the carpal-tarsal joints, said exerciser comprising an elongated horizontal platform, a support for a limbv extremity,',said support including a lower'part and'- an upper part, a hinge connecting said lower partl t'o said platform for rotation about a horizontal axis transverse to the longitudinal axisofthe platform, meanstomount said upper' part on said lowerpartlfor .rotation about theother half of said rapidsaidhorizo'ntal4A axis; a pairl of elongated exible members, each of said members having an end thereof secured to a different means to removably support a plurality of weights, means rotatably guiding said members near said Weight supporting means, means selectively to rotatably guide said membersin front of said support, and rapidly detachable attaching means for connecting the other end of each member to opposite sides of said upper part.

10. An exerciser and measuring instrument for the carpal-tarsal joints, said exerciser comprising an elongated horizontal platform, a support for a limb extremity, said support including a lower part and an upper part, a hinge connecting said lower part to said platform for rotation about a horizontal axis transverse to the longitudinal axis of the platform, means to mount said upper part on said lower part for rotation about an axis transverse to said horizontal axis, means selectively to render said last-named means ineffective, a pair of elongated exible members, each of said members having an end thereof secured to a diffrent means to removably support a plurality of Weights, means rotatably guiding said members near said weight supporting means, means selectively to rotatably guide said members in front of ly detachable attaching means for connecting the other end of each member to opposite sides of said upper part.

11. An exerciser as set forth in claim 10 Wherein the upper part includes a top section, a bottom section and means to disconnectably secure said sections together.

WILLIAM BIERMAN.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PA'IETS saidsupport, and rapid- 

